| multiplex gastrointestinal pathogen panels: implications for infection control. | in the acute care hospital inpatient setting, there is a wide variety of causes for both infectious and noninfectious diarrhea. however, without molecular assays for the wide range of agents causing gastroenteritis, there is no reliable way to determine which individuals should be placed in contact precautions, as recommended by cdc. we tested 158 inpatient diarrheal stool specimens with the filmarray gi panel (biofire diagnostics, salt lake city, ut, usa) that had been stored at -70°c after tes ... | 2015 | 25796558 |
| performance of the present-on-admission indicator for clostridium difficile infection. | the performance of a hospital- and community-onset clostridium difficile infection definition using administrative data with a present-on-admission indicator was compared with definitions using clinical surveillance. for hospital-onset c. difficile infection, there was moderate sensitivity (68%) and high specificity (93%); for community-onset, sensitivity and specificity were high (both 85%). | 2015 | 25792197 |
| is clostridium difficile infection an increasingly common severe disease in adult intensive care units? a 10-year experience. | despite the high concentration of patients with known risk factors for clostridium difficile infection (cdi) in intensive care units (icus), data on icu patients are scarce. the aim of this study was describe the incidence, clinical characteristics, and evolution of cdi in critically ill patients. | 2015 | 25791766 |
| the first clostridium difficile ribotype 027 strain isolated in taiwan. | | 2016 | 25791539 |
| comparison of the vidas c. difficile gdh automated enzyme-linked fluorescence immunoassay (elfa) with another commercial enzyme immunoassay (eia) (quik chek-60), two selective media, and a pcr assay for glud for detection of clostridium difficile in fecal samples. | prevention and management of clostridium difficile infection (cdi) can be improved by rapid and reliable diagnostics. the vidas c. difficile glutamate dehydrogenase assay had performance comparable to that of the quik chek-60 assay (overall agreement, 95%) and a sensitivity of >93%; thus, it is suitable as the first test in two-stage algorithms for a cdi diagnosis. | 2015 | 25788549 |
| emergence and spread of predominantly community-onset clostridium difficile pcr ribotype 244 infection in australia, 2010 to 2012. | we describe an australia-wide clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244. in western australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than 65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. using whole genome sequencing, we confirm ribotype 244 is from the same c. difficile clade as the epidemic ribotype 027. like ribotype 027, it produces toxins a, b, ... | 2015 | 25788254 |
| the cost-benefit of federal investment in preventing clostridium difficile infections through the use of a multifaceted infection control and antimicrobial stewardship program. | to determine the potential epidemiologic and economic value of the implementation of a multifaceted clostridium difficile infection (cdi) control program at us acute care hospitals | 2015 | 25783204 |
| substantial variation in hospital rankings after adjusting for hospital-level predictors of publicly-reported hospital-associated clostridium difficile infection rates. | across 366 california hospitals, we identified hospital-level characteristics predicting increased hospital-associated clostridium difficile infection (ha-cdi) rates including more licensed beds, teaching and long-term acute care (ltac) hospitals, and polymerase chain reaction testing. adjustment for these characteristics impacted rankings in 24% of teaching hospitals, 13% of community hospitals, and 11% of ltac hospitals. | 2015 | 25782902 |
| molecular epidemiology of clostridium difficile infections in children: a retrospective cohort study. | the molecular epidemiology of pediatric clostridium difficile infection (cdi) is poorly understood. we aimed to identify the restriction endonuclease analysis (rea) groups causing cdi and to determine risk factors and outcomes associated with cdi caused by epidemic strains in children. | 2015 | 25782900 |
| cost-effectiveness analysis of fecal microbiota transplantation for recurrent clostridium difficile infection. | clostridium difficile infection (cdi) places a high burden on the us healthcare system. recurrent cdi (rcdi) occurs frequently. recently proposed guidelines from the american college of gastroenterology (acg) and the american gastroenterology association (aga) include fecal microbiota transplantation (fmt) as a therapeutic option for rcdi. the purpose of this study was to estimate the cost-effectiveness of fmt compared with vancomycin for the treatment of rcdi in adults, specifically following g ... | 2015 | 25782899 |
| regional infection control assessment of antibiotic resistance knowledge and practice. | multidrug-resistant organisms (mdros) are an increasing burden among healthcare facilities. we assessed facility-level perceived importance of and responses to various mdros. | 2015 | 25782891 |
| cold-air atmospheric pressure plasma against clostridium difficile spores: a potential alternative for the decontamination of hospital inanimate surfaces. | clostridium difficile spores survive for months on environmental surfaces and are highly resistant to decontamination. we evaluated the effect of cold-air plasma against c. difficile spores. the single-jet had no effect while the multi-jet achieved 2-3 log10 reductions in spore counts and may augment traditional decontamination. | 2015 | 25782039 |
| lack of correlation between bristol stool scale and quantitative bacterial load in clostridium difficile infection. | decision to test for clostridium difficile infection (cdi) is usually made when patients have loose stools with bristol stool score of ≥5. we aimed to assess the relationship between bacterial load of c. difficile and bristol stool scale, as well as stool frequency in stool samples collected from patients infected with the organism. samples were collected at baseline, during therapy, and at the end of therapy. spearman correlation test was used to evaluate these relationships. no correlation bet ... | 2015 | 25780339 |
| idiopathic myointimal hyperplasia of mesenteric veins: rare case of ischemic colitis mimicking inflammatory bowel disease. | idiopathic myointimal hyperplasia of mesenteric veins (imhmv) is a rare and poorly understood ischemic colitis that occurs in the rectosigmoid colon of predominantly young, previously healthy, male patients. a 76-year-old japanese man presented to our hospital with a 1-year history of worsening diarrhea, lower abdominal pain, and weight loss (-6 kg). laboratory evaluation revealed white blood cell count of 13,200/μl, c-reactive protein level of 2.0 mg/dl (normal range, 0.0-0.3), and negative res ... | 2015 | 25777655 |
| clostridium difficile infection seasonality: patterns across hemispheres and continents - a systematic review. | studies have demonstrated seasonal variability in rates of clostridium difficile infection (cdi). synthesising all available information on seasonality is a necessary step in identifying large-scale epidemiological patterns and elucidating underlying causes. | 2015 | 25775463 |
| [current treatment and epidemiology of clostridium difficile infections]. | during the past 10years, clostridium difficile infections (cdi) have become a major public health challenge. their epidemiology has changed with a rise in the number of cases and an increase in severe episodes. recurrence and failure of conventional treatments have become more common. furthermore, a spread of cdi has been observed in the general population-involving subjects without the usual risk factors (unexposed to antibiotic treatment, young people, pregnant women, etc.). all these change a ... | 2015 | 25772664 |
| a highly acid-resistant novel strain of lactobacillus johnsonii no. 1088 has antibacterial activity, including that against helicobacter pylori, and inhibits gastrin-mediated acid production in mice. | a novel strain of lactobacillus johnsonii no. 1088 was isolated from the gastric juice of a healthy japanese male volunteer, and characterized for its effectiveness in the stomach environment. lactobacillus johnsonii no. 1088 was found to have the strongest acid resistance among several lactobacilli examined (>10% of cells survived at ph 1.0 after 2 h), and such a high acid resistance property was a specific characteristic of this strain of l. johnsonii. when cultured with various virulent bacte ... | 2015 | 25771812 |
| comparison of clostridium difficile isolates from individuals with recurrent and single episode of infection. | recurrent clostridium difficile infection (cdi) is an increasing problem, yet reasons for this are poorly understood. attention has been paid to the role of strain, with conflicting association of ribotype 027 and recurrences. | 2015 | 25769665 |
| case of cytomegalovirus colitis in an immunocompetent patient: a rare cause of abdominal pain and diarrhea in the elderly. | cytomegalovirus (cmv) colitis usually occurs in immunocompromised patients after undergoing organ transplantation or chemotherapy. we report the case of a 60-year-old immunocompetent japanese woman who presented with abdominal pain and bloody diarrhea. she was initially diagnosed as having ischemic colitis with pseudomembranous colitis on the basis of her symptoms, clostridium difficile antigen positivity, and colonoscopic findings, which showed ulcer formation from the sigmoid colon to rectum. ... | 2015 | 25767404 |
| nomenclature and functionality of the so-called cfr gene from clostridium difficile. | | 2015 | 25762794 |
| cwp84, a clostridium difficile cysteine protease, exhibits conformational flexibility in the absence of its propeptide. | in recent decades, the global healthcare problems caused by clostridium difficile have increased at an alarming rate. a greater understanding of this antibiotic-resistant bacterium, particularly with respect to how it interacts with the host, is required for the development of novel strategies for fighting c. difficile infections. the surface layer (s-layer) of c. difficile is likely to be of significant importance to host-pathogen interactions. the mature s-layer is formed by a proteinaceous ar ... | 2015 | 25760704 |
| clostridium difficile heterogeneously impacts intestinal community architecture but drives stable metabolome responses. | clostridium difficile-associated diarrhoea (cdad) is caused by c. difficile toxins a and b and represents a serious emerging health problem. yet, its progression and functional consequences are unclear. we hypothesised that c. difficile can drive major measurable metabolic changes in the gut microbiota and that a relationship with the production or absence of toxins may be established. we tested this hypothesis by performing metabolic profiling on the gut microbiota of patients with c. difficile ... | 2015 | 25756679 |
| prevalence and pathogenicity of binary toxin-positive clostridium difficile strains that do not produce toxins a and b. | clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. the main virulence factors of c. difficile are the toxins a (tcda) and b (tcdb). a third toxin, called binary toxin (cdt), can be detected in 17% to 23% of strains, but its role in human disease has not been clearly defined. we report six independent cases of patients with diarrhoea suspected of having c. difficile infection due to strains from toxinotype xi/pcr ribotype 033 or 033-like, an unusual toxinot ... | 2015 | 25755885 |
| predicting the risk for hospital-onset clostridium difficile infection (ho-cdi) at the time of inpatient admission: ho-cdi risk score. | to predict the likelihood of hospital-onset clostridium difficile infection (ho-cdi) based on patient clinical presentations at admission | 2015 | 25753106 |
| accuracy of loop-mediated isothermal amplification for the diagnosis of clostridium difficile infection: a systematic review. | loop-mediated isothermal dna amplification (lamp) is currently used as standalone diagnostic test for c. difficile infection (cdi). we assessed the diagnostic accuracy of lamp for the diagnosis of cdi. we searched 5 databases to identify studies that compared lamp with culture cytotoxicity neutralization assay or anaerobic toxigenic culture (tc) of c. difficile. we used the random-effects model to calculate pooled sensitivities, specificities, diagnostic odds ratios, and their 95% confidence int ... | 2015 | 25752201 |
| acute graft-versus-host disease, invasive aspergillosis and clostridium difficile colitis after peripheral blood stem cell transplantation: a complex network of causalities and a challenge for prevention. | graft-versus-host disease (gvhd) is a known risk factor for invasive aspergillosis (ia), but remains poorly studied in relation to clostridium difficile infection (cdi). we report a case of a 58-years-old patient who developed an ia within a protected room, cdi and gvhd after allogeneic allogeneic peripheral blood stem cell transplantation (pbsct). factors associated with this complex condition in patients receiving allogeneic pbsct need to be identified. | 2015 | 25749258 |
| faecal microbiota transplantation: key points to consider. | faecal microbiota transplantation (fmt) from a healthy donor has become the gold standard treatment for patients suffering from recurrent clostridium difficile infection where antibiotic treatment (with vancomycin, metronidazole or fidaxomicin) has failed. fmt eradicates c. difficile and helps restore the recipient's intestinal flora, but its mechanism of action remains unclear. since fmt's complex and highly variable composition cannot be easily characterized - nor its quality routinely assesse ... | 2015 | 25747146 |
| inhibition of adhesion of clostridium difficile to human intestinal cells after treatment with serum and intestinal fluid isolated from mice immunized with nontoxigenic c. difficile membrane fraction. | diarrhea and pseudomembrane colitis caused by clostridium difficile infection is a global health concern because of the high recurrence rate after standard antibiotic therapy. vaccination presents a powerful countermeasure against disease recurrence. in this study, mice vaccinated with the nontoxigenic c. difficile membrane fraction generated a marked immune response to the antigen, as demonstrated by the serum igg and intestinal fluid iga levels. significantly, pretreatment with harvested igg- ... | 2015 | 25745878 |
| [clostridium difficile, are all our patients diagnosed?]. | a close correlation between clinical and microbiological diagnosis in clostridium difficile infection (cdi) is very important to identify how severe is this health problem, and to approach its correct management of it, individually and as a population problem. | 2016 | 25743538 |
| clostridium difficile toxin b intoxicated mouse colonic epithelial ct26 cells stimulate the activation of dendritic cells. | clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis mainly through two exotoxins tcda and tcdb that target intestinal epithelial cells. dendritic cells (dcs) play an important role in regulating intestinal inflammatory responses. in the current study, we explored the interaction of tcdb-intoxicated epithelial cells with mouse bone marrow-derived dcs. tcdb induced cell death and heat shock protein translocation in mouse intestinal epithelial ct26 cells. the in ... | 2015 | 25743476 |
| long-term outcomes of an antimicrobial stewardship program implemented in a hospital with low baseline antibiotic use. | to evaluate the long-term outcomes of an antimicrobial stewardship program (asp) implemented in a hospital with low baseline antibiotic use. | 2015 | 25740560 |
| [prevalence of clostridium difficile infection in hospitalized patients with diarrhea: results of a french prospective multicenter bi-annual point prevalence study]. | clostridium difficile infections represent the major cause of healthcare-associated diarrhea. the objective of the study was to determine the incidence of c. difficile infection (cdi) in 2012 and to assess the under-estimation of the disease in france. | 2015 | 25737062 |
| urinary tract infections in male veterans with human immunodeficiency virus. | treatment duration for men with urinary tract infection (uti) and human immunodeficiency virus (hiv) infection is unknown. fiscal year 2009 veterans affairs administrative data were used to compare men with hiv and uti with non-hiv men with uti. antimicrobial selection and duration were similar. shorter treatment (≤7 days) did not affect recurrence, suggesting that treatment beyond 7 days may be unnecessary. | 2014 | 25734168 |
| novel fidaxomicin treatment regimens for patients with multiple clostridium difficile infection recurrences that are refractory to standard therapies. | reports of fidaxomicin treatment for patients with multiple recurrent clostridium difficile infections ([mrcdi] ie, more than 2 cdi episodes) indicate symptomatic response to this agent, but 50% have subsequent mrcdi episodes. in an effort to improve outcomes in patients with mrcdi we used novel regimens of fidaxomicin based on strategies used with vancomycin. of 8 patients who received a 10-day chaser of fidaxomicin given twice daily after a course of vancomycin, 3 (38%) experienced a subsequen ... | 2014 | 25734139 |
| determinants of clostridium difficile infection incidence across diverse united states geographic locations. | clostridium difficile infection (cdi) is no longer restricted to hospital settings, and population-based incidence measures are needed. understanding the determinants of cdi incidence will allow for more meaningful comparisons of rates and accurate national estimates. | 2014 | 25734120 |
| learning data-driven patient risk stratification models for clostridium difficile. | although many risk factors are well known, clostridium difficile infection (cdi) continues to be a significant problem throughout the world. the purpose of this study was to develop and validate a data-driven, hospital-specific risk stratification procedure for estimating the probability that an inpatient will test positive for c difficile. | 2014 | 25734117 |
| id learning unit: understanding and interpreting testing for clostridium difficile. | understanding and interpreting the molecular tests for clostridium difficile is challenging because there are several different types of assays and most laboratories combine multiple tests in order to assess for presence of disease. this learning unit demonstrates the basic principles of each test along with its strengths and weaknesses, and illustrates how the tests are used in clinical practice. | 2014 | 25734081 |
| in vitro selection of a single-stranded dna molecular recognition element against clostridium difficile toxin b and sensitive detection in human fecal matter. | toxin b is one of the major virulence factors of clostridium difficile, a bacterium that is responsible for a significant number of diarrhea cases in acute care settings. due to the prevalence of c. difficile induced diarrhea, rapid and correct diagnosis is crucial in the disease management. in this study, we have employed a stringent in vitro selection method to identify single-stranded dna molecular recognition elements (mre) specific for toxin b. at the end of the 12-round selection, one mre ... | 2015 | 25734010 |
| continuous proton pump inhibitor therapy and the associated risk of recurrent clostridium difficile infection. | clostridium difficile infection (cdi) is associated with significant morbidity, mortality, and a high risk of recurrence. proton pump inhibitor (ppi) use is associated with an initial episode of cdi, and ppis are frequently overprescribed. for many, the use of ppis could likely be discontinued before cdi recurrence. | 2015 | 25730198 |
| randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent clostridium difficile infection. | faecal microbiota transplantation (fmt) from healthy donors is considered an effective treatment against recurrent clostridium difficile infection. | 2015 | 25728808 |
| reduction in clostridium difficile environmental contamination by hospitalized patients treated with fidaxomicin. | fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with clostridium difficile infection (cdi). this study investigated whether fidaxomicin for treatment of all patients with cdi reduced c. difficile environmental contamination. surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. patients treated with fidaxomicin wer ... | 2015 | 25728208 |
| predictors of asymptomatic clostridium difficile colonization on hospital admission. | clostridium difficile (cd) is the leading cause of health care-associated diarrhea and can result in asymptomatic carriage. rates of asymptomatic cd colonization on hospital admission range from 1.4%-21%. the objective of this study was to evaluate host and bacterial factors associated with colonization on admission. | 2015 | 25728150 |
| understanding the current state of infection prevention to prevent clostridium difficile infection: a human factors and systems engineering approach. | achieving and sustaining high levels of health care worker (hcw) compliance with contact isolation precautions is challenging. the aim of this study was to determine hcw work system barriers to and facilitators of adherence to contact isolation for patients with suspected or confirmed clostridium difficile infection (cdi) using a human factors and systems engineering approach. | 2015 | 25728149 |
| automated 3d rna structure prediction using the rnacomposer method for riboswitches. | understanding the numerous functions of rnas depends critically on the knowledge of their three-dimensional (3d) structure. in contrast to the protein field, a much smaller number of rna 3d structures have been assessed using x-ray crystallography, nmr spectroscopy, and cryomicroscopy. this has led to a great demand to obtain the rna 3d structures using prediction methods. the 3d structure prediction, especially of large rnas, still remains a significant challenge and there is still a great dema ... | 2015 | 25726459 |
| masking autoprocessing of clostridium difficile toxin a by the c-terminus combined repetitive oligo peptides. | clostridium difficile toxin a and b (tcda and tcdb) are the major virulence factors of the bacterium, both of which consist of two enzymatic domains: an effector glucosyltransferase domain (gtd) and a cysteine protease domain (cpd) responsible for autocleavage and release of gtd. although the cpds from both toxins share a similar structure and mechanism of hexakisphosphate (insp6)-induced activation, tcda is substantially less sensitive to the autocleavage as compared with tcdb. in this study, w ... | 2015 | 25725153 |
| the association of antibiotic treatment regimen and hospital mortality in patients hospitalized with legionella pneumonia. | guidelines recommend azithromycin or a quinolone antibiotic for treatment of legionella pneumonia. no clinical study has compared these strategies. | 2015 | 25722195 |
| reactive oxygen species involved in ct26 immunogenic cell death induced by clostridium difficile toxin b. | immunogenic cell death (icd) is a new concept appeared in recent years. despite growing interests of research on icd, the circumstances that trigger immune responses against dying tumor cells remain largely unknown. it was demonstrated that recombinant clostridium difficile toxin b (rtcdb) can induce icd in intoxicated cells, but its mechanism remains unclear. this work aims at exploring whether reactive oxygen species (ros) involved in rtcdb induced icd using the chemical agent n-acetyl cystein ... | 2015 | 25721381 |
| a case of toxic megacolon caused by clostridium difficile infection and treated with fecal microbiota transplantation. | clostridium difficile infection. the mortality rate of fulminant c. difficile infection is reported to be as high as 50%. fecal microbiota transplantation is a highly effective treatment in patients with recurrent or refractory c. difficile infection. however, there are few published articles on the use of such transplantation for fulminant c. difficile infection. here, we report on a patient with toxic megacolon complicated by c. difficile infection who was treated successfully with fecal mi-cr ... | 2015 | 25721003 |
| solution structure and dna binding of the catalytic domain of the large serine resolvase tnpx. | the transfer of antibiotic resistance between bacteria is mediated by mobile genetic elements such as plasmids and transposons. tnpx is a member of the large serine recombinase subgroup of site-specific recombinases and is responsible for the excision and insertion of mobile genetic elements that encode chloramphenicol resistance in the pathogens clostridium perfringens and clostridium difficile. tnpx consists of three structural domains: domain i contains the catalytic site, whereas domains ii ... | 2015 | 25720550 |
| molecular testing for viral and bacterial enteric pathogens: gold standard for viruses, but don't let culture go just yet? | contemporary diagnostic microbiology is increasingly adopting molecular methods as front line tests for a variety of samples. this trend holds true for detection of enteric pathogens (ep), where nucleic acid amplification tests (naat) for viruses are well established as the gold standard, and an increasing number of commercial multi-target assays are now available for bacteria and parasites. naat have significant sensitivity and turnaround time advantages over traditional methods, potentially re ... | 2015 | 25719855 |
| molecular methods for detecting and typing of clostridium difficile. | since the early 2000s, clostridium difficile has emerged as a major international pathogen. recently, strains of c. difficile in circulation appear to be changing, with greater diversity, leading to challenges for diagnostics and surveillance. currently molecular diagnostic methods are favoured for their high sensitivity and rapid processing times; however, a number of issues still exist with molecular tests, in particular high cost, low clinical specificity and failure to detect some variant c. ... | 2015 | 25719853 |
| differential immunodetection of toxin b from highly virulent clostridium difficile bi/nap-1/027. | we developed a simple immunoassay capable of differentially detecting toxin b from highly virulent strains of clostridium difficile (bi/nap-1/027) in stool. this assay can simultaneously confirm the presence of in vivo toxin production and provide strain-related information relevant to infection control epidemiology and disease prognosis. | 2015 | 25716449 |
| toxin synthesis by clostridium difficile is regulated through quorum signaling. | clostridium difficile infection (cdi) is dramatically increasing as a cause of antibiotic- and hospital-associated diarrhea worldwide. c. difficile, a multidrug-resistant pathogen, flourishes in the colon after the gut microbiota has been altered by antibiotic therapy. consequently, it produces toxins a and b that directly cause disease. despite the enormous public health problem posed by this pathogen, the molecular mechanisms that regulate production of the toxins, which are directly responsib ... | 2015 | 25714717 |
| high-throughput analysis of gene essentiality and sporulation in clostridium difficile. | clostridium difficile is the most common cause of antibiotic-associated intestinal infections and a significant cause of morbidity and mortality. infection with c. difficile requires disruption of the intestinal microbiota, most commonly by antibiotic usage. therapeutic intervention largely relies on a small number of broad-spectrum antibiotics, which further exacerbate intestinal dysbiosis and leave the patient acutely sensitive to reinfection. development of novel targeted therapeutic interven ... | 2015 | 25714712 |
| burden of clostridium difficile infection in the united states. | the magnitude and scope of clostridium difficile infection in the united states continue to evolve. | 2015 | 25714160 |
| is combination therapy for carbapenem-resistant klebsiella pneumoniae the new standard of care? | carbapenem-resistant klebsiella pneumoniae causes serious nosocomial infections and therapeutic options are limited. there is increasing evidence suggesting that combination antibiotic therapy is more effective than monotherapy and leads to better outcomes. however, questions remain about which regimen is optimal and how to balance the potential benefits of combination therapy versus the risks and possible complications (e.g., toxicity, increased costs, clostridium difficile infection). well-des ... | 2015 | 25711690 |
| separating the microbiome from the hyperbolome. | microbiome-based therapies are moving quickly towards the clinic, with successes including fecal microbial transplants for recurring clostridium difficile, hints of new antibiotics to come, and possible new microbial biomarkers for common complex diseases. can the microbiome live up to its hype? | 2015 | 25709718 |
| emerging influence of the intestinal microbiota during allogeneic hematopoietic cell transplantation: control the gut and the body will follow. | the intestinal microbiota has many critical roles in maintaining gastrointestinal epithelial and gastrointestinal systemic immune homeostasis. this review provides insight into how allogeneic hematopoietic cell transplantation (hct) and its associated complications and supportive care therapies affect the microbiota. additionally, the review discusses how preservation and restoration of the microbiota might be advantageous in decreasing hct-related morbidity and mortality. | 2015 | 25708215 |
| asymptomatic carriers of toxigenic c. difficile in long-term care facilities: a meta-analysis of prevalence and risk factors. | the impact of clostridium difficile colonization in c. difficile infection (cdi) is inadequately explored. as a result, asymptomatic carriage is not considered in the development of infection control policies and the burden of carrier state in long-term care facilities (ltcfs) is unknown. | 2015 | 25707002 |
| hospital ward antibiotic prescribing and the risks of clostridium difficile infection. | only a portion of hospital-acquired clostridium difficile infections can be traced back to source patients identified as having symptomatic disease. antibiotic exposure is the main risk factor for c difficile infection for individual patients and is also associated with increased asymptomatic shedding. contact with patients taking antibiotics within the same hospital ward may be a transmission risk factor for c difficile infection, but this hypothesis has never been tested. | 2015 | 25705994 |
| impact of sink location on hand hygiene compliance for clostridium difficile infection. | hand hygiene with soap and water after the care of a patient with clostridium difficile infection is essential to reduce nosocomial transmission in an outbreak situation. factors that may pose barriers to user completion of infection prevention measures, such as hand hygiene, are of interest. we undertook a quantitative study to evaluate the relationship between sink location and compliance with handwashing among health care workers and visitors in a surgical transplant unit. we found that place ... | 2015 | 25704256 |
| fecal microbiota transplantation (fmt) for clostridium difficile infection: focus on immunocompromised patients. | clostridium difficile infection (cdi) is an emerging problem worldwide associated with significant morbidity, mortality, recurrence rates and healthcare costs. immunosuppressed patients, including hiv-seropositive individuals, solid organ transplant recipients, patients with malignancies, hematopoietic stem cell transplant recipients, and patients with inflammatory bowel disease are increasingly recognized as being at higher risk of developing cdi where it may be associated with significant comp ... | 2015 | 25703532 |
| pan-european longitudinal surveillance of antibiotic resistance among prevalent clostridium difficile ribotypes. | clostridium difficile infection remains a major healthcare burden. until the recent introduction of fidaxomicin, antimicrobial treatments were limited to metronidazole and vancomycin. the emergence of epidemic c. difficile pcr ribotype 027 and its potential link to decreased antibiotic susceptibility highlight the lack of large-scale antimicrobial susceptibility and epidemiological data available. we report results of epidemiological and antimicrobial susceptibility investigations of c. difficil ... | 2015 | 25701178 |
| case-control comparison of bacterial and protozoan microorganisms associated with gastroenteritis: application of molecular detection. | the introduction of molecular detection of infectious organisms has led to increased numbers of positive findings, as observed for pathogens causing gastroenteritis (ge). however, because little is known about the prevalence of these pathogens in the healthy asymptomatic population, the clinical value of these additional findings is unclear. a case-control study was carried out in a population of patients served by general practitioners in the netherlands. a total of 2710 fecal samples from case ... | 2015 | 25700890 |
| genomic diversity of clostridium difficile strains. | approaches to exploring clostridium difficile genomic diversity have ranged from molecular typing methods to use of comparative genome microarrays and whole genome sequence comparisons. the c. difficile population structure is clonal and distributed into six clades, which correlate well with mlst sts (multilocus sequence types) and pcr ribotypes. however, toxigenic strains and strains with increased virulence are distributed throughout several clades. here we summarize studies on c. difficile ge ... | 2015 | 25700631 |
| clostridium difficile infection: a serbian single-center experience. | clostridium difficile infection (cdi) is the most common cause of hospital-acquired diarrhea. severity of cdi is associated with advanced age and co-morbidities. the clinical spectrum varies from mild watery diarrhea to severe fulminant pseudomembranous colitis with complications. | 2015 | 25699487 |
| risk factors and clinical outcomes of candidaemia in patients treated for clostridium difficile infection. | the alterations occurring in the intestinal flora during clostridium difficile infection (cdi) may promote the translocation of candida to the blood and the development of candidaemia. the aim of our study was to analyse clinical findings of these patients to determine the risk factors associated with the development of candidaemia subsequent to cdi. we compared 35 patients with candidaemia subsequent to cdi with 105 patients with cdi. patients with candidaemia showed more severe infections and ... | 2015 | 25698658 |
| the recombinant lactococcus lactis oral vaccine induces protection against c. difficile spore challenge in a mouse model. | clostridium difficile infection (cdi) causes nosocomial antibiotic-associated diarrhea and colitis in the developed world. two potent cytotoxins, toxin a (tcda) and toxin b (tcdb) are the virulence factors of this disease and can be a good vaccine candidate against cdi. in the present study, we genetically engineered lactococcus lactis to express the nontoxic, recombinant fragments derived from tcda and tcdb c-terminal receptor binding domains (tcd-ac and tcd-bc) as an oral vaccine candidate. th ... | 2015 | 25698490 |
| perspectives on lantibiotic discovery - where have we failed and what improvements are required? | the increasing resistance of bacteria to conventional antimicrobial therapy within both the nosocomial and community environment has enforced the urgent requirement for the discovery of novel agents. this has stimulated increased research efforts within the field of lantibiotic discovery. lantibiotics are ribosomally synthesised, post-translationally modified antimicrobial peptides that exhibit antimicrobial activity against a range of multi-drug-resistant (mdr) bacteria. the success of these ag ... | 2015 | 25697059 |
| state law mandates for reporting of healthcare-associated clostridium difficile infections in hospitals. | us state and territorial laws were reviewed to identify clostridium difficile infection reporting mandates. twenty states require reporting either under state law or by incorporating federal centers for medicare & medicaid services' reporting requirements. although state law mandates are more common, the incorporation of federal reporting requirements has been increasing. | 2015 | 25695178 |
| clostridium difficile infection (cdi) severity and outcome among patients infected with the nap1/bi/027 strain in a non-epidemic setting. | determine whether the nap1 strain identified by polymerase chain reaction (pcr)-based stool assay is correlated with cdi severity and clinical outcomes. | 2015 | 25695169 |
| clostridium difficile recurrence is a strong predictor of 30-day rehospitalization among patients in intensive care. | while incidence, mortality, morbidity, and recurrence rates of c. difficile infection (cdi) among the critically ill have been investigated, the impact of its recurrence on 30-day rehospitalization (read), an important policy focus, has not been examined. | 2015 | 25695168 |
| protease-sensitive inhibitory activity of cell-free supernatant of lactobacillus crispatus 156 synergizes with ciprofloxacin, moxifloxacin and streptomycin against pseudomonas aeruginosa: an in vitro study. | ciprofloxacin and streptomycin are frequently prescribed for the treatment of medical conditions originating due to infection by pseudomonas aeruginosa. however, fluoroquinolone administration has been linked to the outgrowth of clostridium difficile pathogen, especially in immunocompromised patients. secondly, frequent administration of antibiotics may lead to development of resistance in the pathogens. thus, there is a need to explore innovative adjunct therapies to lower the therapeutic doses ... | 2015 | 25693845 |
| refractory clostridium difficile infection cured with fecal microbiota transplantation in vancomycin-resistant enterococcus colonized patient. | the rates and severity of clostridium difficile infections, including pseudomembranous colitis, have increased markedly. however, there are few effective treatments for refractory or recurrent c. difficile infections and the outcomes are poor. fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. cure rates of >90% are being consistently reported from mu ... | 2015 | 25691847 |
| ambush of clostridium difficile spores by ramoplanin: activity in an in vitro model. | clostridium difficile infection (cdi) is a gastrointestinal disease caused by c. difficile, a spore-forming bacterium that in its spore form is tolerant to standard antimicrobials. ramoplanin is a glycolipodepsipeptide antibiotic that is active against c. difficile with mics ranging from 0.25 to 0.50 μg/ml. the activity of ramoplanin against the spores of c. difficile has not been well characterized; such activity, however, may hold promise, since posttreatment residual intraluminal spores are l ... | 2015 | 25691641 |
| impact of clostridium difficile recurrence on hospital readmissions. | the impact of recurrent clostridium difficile infections (cdis) on hospital readmissions is unknown. the objective of this study was to determine whether recurrent cdi was independently associated with the number of hospital readmissions and days readmitted. | 2015 | 25690876 |
| fecal microbiota transplantation in patients with cancer undergoing treatment. | fecal microbiota transplantation (fmt) is a technique used to restore the normal body flora to the gut in cases of clostridium difficile infection (cdi). it involves instillation of the stool of a healthy donor through a nasogastric tube or colonoscopy into the gastrointestinal tract of the patient. more research is needed to determine the parameters of fmt use in patients with cancer. | 2015 | 25689657 |
| risk factors for systemic vancomycin exposure following administration of oral vancomycin for the treatment of clostridium difficile infection. | to identify risk factors for systemic exposure to vancomycin (van) following administration of oral vancomycin (pov) for the treatment of clostridium difficile infection (cdi). | 2015 | 25689243 |
| fecal microbiota transplantation for clostridium difficile infection--reply. | | 2015 | 25688788 |
| fecal microbiota transplantation for clostridium difficile infection. | | 2015 | 25688787 |
| impact of polymerase chain reaction testing on clostridium difficile infection rates in an acute health care facility. | two rapid methods of clostridium difficile infection (cdi) diagnosis were compared between june 2012 and march 2013: a genexpert (cepheid, sunnyvale, calif) polymerase chain reaction (pcr) test and an enzyme immunoassay (eia). the influence of these methods on the detection of hospital-acquired cdi and identification of cdi outbreaks was evaluated. we tested 1,592 stool samples for c difficile. the genexpert pcr test identified 211 positive samples (68 determined to be hospital-acquired infectio ... | 2015 | 25687359 |
| rapid spread of clostridium difficile nap1/027/st1 in chile confirms the emergence of the epidemic strain in latin america. | clostridium difficile infection has gained importance in recent years as a result of the rapid spread of epidemic strains, including hypervirulent strains. this study reports the molecular epidemiology of c. difficile obtained from hospitalized patients in chile. seven hundred and nineteen isolates of toxigenic c. difficile from 45 hospitals across the country were characterized through toxin profile, pulsed-field gel electrophoresis (pfge), and sequencing of the tcdc gene. in addition, polymera ... | 2015 | 25687254 |
| predicting clostridium difficile infection in diabetic patients and the effect of metformin therapy: a retrospective, case-control study. | data on risk factors for clostridium difficile infection (cdi) in diabetic patients are scarce. recently, it has been shown that metformin increases the bacteroidetes/firmicutes ratio; therefore, it may yield a protective effect against cdi. we aimed to assess risk factors for cdi in diabetic patients beyond antibiotic treatment, and to determine the impact of metformin therapy on the development of cdi in these patients. in this retrospective, case-control study, all consecutive cdi diabetic pa ... | 2015 | 25686730 |
| clostridium difficile in the long-term care facility: prevention and management. | residents of long-term care facilities are at high risk for clostridium difficile infection due to frequent antibiotic exposure in a population already rendered vulnerable to infection due to advanced age, multiple comorbid conditions and communal living conditions. moreover, asymptomatic carriage of toxigenic c. difficile and recurrent infections are prevalent in this population. here, we discuss epidemiology and management of c. difficile infection among residents of long-term care facilities. ... | 2015 | 25685657 |
| adherence to and outcomes associated with a clostridium difficile guideline at a large teaching institution. | the incidence and virulence of clostridium difficile infection (cdi) has recently increased. national cdi treatment guidelines stratify patients based on clinical symptoms and recommend treatment based on severity of illness. in 2009, advocate lutheran general hospital (park ridge, illinois) adopted guidelines with treatment algorithms identical to the national guidelines. the purpose of this study was to determine whether patients were being treated in accordance with the cdi guidelines and whe ... | 2015 | 25684800 |
| variation in germination of clostridium difficile clinical isolates correlates to disease severity. | over the past two decades, clostridium difficile infections have been increasing in both number and severity throughout the world. as with other spore forming bacteria, germination is a vital step in the life cycle of this pathogen. studies have examined differences in sporulation and toxin production among a number of c. difficile clinical isolates; however, few have examined differences in germination and the relationship between this phenotype and disease severity. here, over 100 c. difficile ... | 2015 | 25681667 |
| automated tracking and ordering of precautions for multidrug-resistant organisms. | the transmission and infection risk associated with multidrug-resistant organism (mdro) carriers necessitates surveillance and tracking to provide proper contact precautions. as mdros increase in scope, automated electronic health record (ehr) systems may help with surveillance demands. | 2015 | 25681303 |
| development and validation of an internationally-standardized, high-resolution capillary gel-based electrophoresis pcr-ribotyping protocol for clostridium difficile. | pcr-ribotyping has been adopted in many laboratories as the method of choice for c. difficile typing and surveillance. however, issues with the conventional agarose gel-based technique, including inter-laboratory variation and interpretation of banding patterns have impeded progress. the method has recently been adapted to incorporate high-resolution capillary gel-based electrophoresis (ce-ribotyping), so improving discrimination, accuracy and reproducibility. however, reports to date have all r ... | 2015 | 25679978 |
| [clostridium difficile spores and its relevance in the persistence and transmission of the infection]. | c. difficile is an anaerobic spore former pathogen and the most important etiologic agent of nosocomial and community acquired antibiotics associated diarrheas. c. difficile infections (cdi) are responsible for an elevated rate of morbidity in developed and developing countries. although the major virulence factors responsible for clinical symptoms of cdi are the two toxins tcda and tcdb, c. difficile spores are the main vehicle of infection, persistence and transmission of cdi. recent work has ... | 2014 | 25679927 |
| [performance of prognostic index in severe clostridium difficile-associated infection: retrospective analysis in a university hospital]. | by consensus severe, clostridium difficile-associated infection (cdai) is one that results in hospitalization in icu, colectomy or death within 30 days. multiple prognostic indices (ip) attempt to predict these adverse events. | 2014 | 25679920 |
| preface: clostridium difficile infection. | | 2015 | 25677709 |
| the prospect for vaccines to prevent clostridium difficile infection. | clostridium difficile is a spore-forming anaerobic gram-positive organism that is the leading cause of antibiotic-associated nosocomial infectious diarrhea in the western world. this article describes the evolving epidemiology of c difficile infection (cdi) in the twenty-first century, evaluates the importance of vaccines against the disease, and defines the roles of both innate and adaptive host immune responses in cdi. the effects of passive immunotherapy and active vaccination against cdi in ... | 2015 | 25677708 |
| the potential of probiotics to prevent clostridium difficile infection. | exposure to antibiotics is the major risk factor for clostridium difficile diarrhea (cdd), suggesting that impairment of colonization resistance due to depletion of the gut flora is a significant underlying disease susceptibility factor. many properties of probiotic organisms indicate that they may be able to replenish the depleted gut flora and restore colonization resistance. however, despite numerous clinical trials, the evidence base for probiotics in the prevention of cdd remains weak. a re ... | 2015 | 25677707 |
| the morbidity, mortality, and costs associated with clostridium difficile infection. | clostridium difficile infection (cdi) is the most common cause of infectious health care-associated diarrhea and is a major burden to patients and the health care system. the incidence and severity of cdi remain at historically high levels. this article reviews the morbidity, mortality, and costs associated with cdi. | 2015 | 25677706 |
| fecal microbiota transplantation for the management of clostridium difficile infection. | this article discusses the use of fecal microbiota transplantation (fmt) for the treatment of recurrent clostridium difficile infection (cdi). the disruption of the normal gut microbiota is central to the pathogenesis of cdi, and disruption persists in recurrent disease. the use of fmt for recurrent cdi is characterized by a high response rate and short term safety is excellent, although the long-term effects of fmt are as yet unknown. | 2015 | 25677705 |
| is the prevalence of antibiotic-resistant organisms changing in canadian hospitals? comparison of point-prevalence survey results in 2010 and 2012. | a national point-prevalence survey for infection or colonization with methicillin-resistant staphylococcus aureus (mrsa) and vancomycin-resistant enterococcus (vre), and for clostridium difficile infection (cdi) was done in canadian hospitals in 2010. a follow-up survey was done in november 2012 to determine whether there were any changes in the prevalence of these organisms; we also determined the prevalence of extended-spectrum β-lactamase (esbl)-producing enterobacteriaceae, and carbapenem-re ... | 2015 | 25677630 |
| faecal microbiota transplantation for clostridium difficile infection in the united kingdom. | faecal microbiota transplantation (fmt) has been shown to be highly effective in treating recurrent clostridium difficile infection, but to date there have been no data from the united kingdom. an electronic survey was developed at portsmouth hospitals' national health service (nhs) trust and sent out to uk hospital specialists utilizing the contact databases of the british infection association and the royal college of gastroenterologists. a total of 162 responses were received, representing ne ... | 2015 | 25677629 |
| potential role of post-transplant hypogammaglobulinemia in the risk of clostridium difficile infection after kidney transplantation: a case-control study. | to identify reversible risk factors for clostridium difficile infection (cdi) after kidney transplantation (kt) that could lead to a reduction in its incidence and associated complications. | 2015 | 25676130 |
| clostridium difficile pcr ribotype 027 emerges in taiwan. | clostridium difficile pcr ribotype 027 is a hypervirulent strain that has caused significant nosocomial diarrhea in many countries but has not yet been reported or isolated in taiwan previously. here, we present the characteristics of a case of c. difficile pcr ribotype 027 identified in taiwan. taiwan is located in a key transportation center of asia. this report is important for alerting hospitals and public health departments in asia about the emergence of this hypervirulent strain so that cl ... | 2015 | 25672348 |
| immune-based treatment and prevention of clostridium difficile infection. | clostridium difficile (c. difficile) causes over 500,000 infections per year in the us, with an estimated 15,000 deaths and an estimated cost of $1-3 billion. moreover, a continual rise in the incidence of severe c. difficile infection (cdi) has been observed worldwide. currently, standard treatment for cdi is the administration of antibiotics. while effective, these treatments do not prevent and may contribute to a disease recurrence rate of 15-35%. prevention of recurrence is one of the most c ... | 2014 | 25668664 |